Betty Uihlein is on oxygen 24 hours a day. She smoked from 16 to her 70s, when she developed emphysema. / The Enquirer/Patrick Reddy

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"I always had a cigarette,'' she said. "With my oldest son, I'd had the epidural and was lying in bed waiting and the nurse came in and said, 'Betty, put out your cigarette. We're taking you to the delivery room.' "

Uihlein, 86, was 16 when she started smoking, and she held onto the habit for more than 60 years.

"That was the thing to do when we were young," she said. "We thought it was sophisticated. Nobody made much of an issue that it was bad for you. It was the 1960s before anybody said it was a problem. But by that time, we'd all been smoking for 20 years."

Uihlein, who lives in a Kenwood retirement home, survived two bouts of breast cancer but never developed lung cancer. She did watch friends die from the disease, though.

Uihlein quit smoking nine years ago after she learned she had emphysema. About 10 million American adults have the disease.

Emphysema isn't cancer, but it is debilitating. Tiny air sacs in the lungs that normally look like bunches of grapes shrivel and die off, gradually reducing the lungs' ability to exchange air.

As the disease progresses, lung tissue gets stiffer, and eventually, the patient can't fully inhale or exhale. They can never really catch their breath.

Smoking is the main cause of emphysema. There's no cure for the disease, which can contribute to heart failure.

Uihlein has used oxygen for about six years. At first, she needed it only when she was active. Now, she's on it 24 hours a day and she relies on a wheelchair.

Uihlein said she's speaking out now to warn others not to start.

"I would recommend that they see how they might end up like me, with a hose in your nose," she said.

At times, she misses her cigarettes.

"I don't think you ever get over it. Some days I'll be sitting here and watching TV and I'll think, 'I want a cigarette.' It's hard."